Only when we get over our testing obsession can a cough be ‘just a cough’ again

The UK has upped its capacity for delivery of lateral flow tests to seven million a day, while 100,000 more PCR booking slots per day have been made available since mid-December. But is all this preventing us from, rather than helping us to, get back to normal?

Chris Smith, a consultant virologist and lecturer at the University of Cambridge, argues it depends on the context. “There are circumstances where testing and self-isolation are very useful and some where it’s a blunderbuss approach,” he says.

“Testing has its place and is very useful in outbreak situations and healthcare management situations because you can then control who’s got what and where you put them. But at a population level, when you’re at a [point] where [infections] are either rare or trivial, then its utility is much less clear.”

We don’t screen for the common cold, for instance, since the cost of doing so would vastly outweigh the benefits. Covid, admittedly, isn’t quite the same: the UK reported a further 439 deaths only yesterday. 

But it seems there are signs our focus on testing is ending and that we are already heading towards a mode of living with Covid that involves less self-monitoring: from February 11, double-jabbed travellers arriving in the UK will no longer have to do either a lateral flow or a PCR.

Still, if we stop testing ourselves, we won’t know whether we need to self-isolate or not. (The current self-isolation regulations run out on March 24 and are not expected to be renewed.) Does it matter if we don’t find out if we have Covid and don’t stay at home? It depends on what impact our failure to isolate would have, argues Dr Smith.

“It’s not a black and white thing,” he says. “One case in a care home could quite quickly turn into 20 cases and 20 deaths. One case in a classroom could turn into 20 cases with no consequences whatsoever.” In the end, says Dr Smith, it’s down to common sense. If you’re going to travel on public transport and sit in meetings with colleagues all day, it is probably better not to go in and spread your germs around, he suggests. Likewise if you’re going to meet vulnerable relatives. 

Other experts remain adamant the only way to get back to normal is by suppressing Covid infections themselves, rather than suppressing the detection and reporting of them. “The virus multiplies when it infects somebody. To remove that multiplication you’ve got to test,” says Dr Bharat Pankhania, a senior clinical lecturer in medicine at the University of Exeter. “When you remove [it] little by little you eventually reach a state where humans are not found [by the virus]. Then you can stop testing. But right now we’re not in that place where we can say ‘actually we can stop testing’.”

As for whether scrapping testing will instantly allay our newfound health anxiety, Blair is doubtful. “Health anxiety is not logical,” she says. “[But] it will fade with time.”

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